NPIMap

Organization Active NPI

Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

Doing business as Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien

  • Rural Health Clinic/Center
  • Prairie Du Chien, WI
National Provider Identifier
1003453119
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC.
Doing business as
Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien
Mayo Clinic Health System-Prairie du Chien
Practice address
800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone
(608) 326-0808
NPI assigned
Dec 9, 2019
Last updated
Feb 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Adam Smith
Title
Cfo
Phone
(715) 838-5275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698

Mailing address

PO Box 860056
Minneapolis, MN 55486-0056

Other names 3

  • Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien Doing business as
  • Mayo Clinic Health System-Prairie du Chien Doing business as
  • Mayo Clinic Health System-Franciscan Medical Center, Inc. Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200325003057 WI Part A Provider - Rural Health Clinic 0345152443 Practice locations: Prairie Du Chien, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003453119. Details of each certification follow.

Rural health clinic certification: CCN 528625

Legal name
MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION INC
Doing business as
MAYO CLINIC HEALTH SYSTEM - PRAIRIE DU CHIEN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 21, 2021
Last certification
May 21, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1888 in WI
Enrollment address
800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Related CCNs
521305

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0964982Mayo Clinic Health System in Prairie Du Chein800 E Blackhawk Ave, Prairie Du Chien, WI 53821AccreditationSep 13, 2026

National Provider Directory

National Provider Directory
Tax ID family
Waukon Family Practice5 organizations share this tax ID, including this one
Part of
Waukon Family Practice

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew J Olmstead Individual Corporate DirectorBoard Member Jan 1, 2025
Paul Molling Individual Corporate OfficerVice Chair Mar 11, 2026
Corporate DirectorBoard Member Mar 11, 2026
Franklin K Ackerman Individual Corporate OfficerSecretary Jan 1, 2025
Jason Beckermann Individual Corporate DirectorBoard Member Jan 1, 2025
Timothy J Young Individual Corporate DirectorBoard Member Jan 1, 2025
Richard a Helmers Individual Corporate OfficerCeo & Chair Mar 16, 2024
Corporate DirectorBoard Member Mar 16, 2024
Tanner T Holst Individual W-2 Managing EmployeeVice Chair Administration Oct 1, 2021
Lisa Gillette Individual Corporate DirectorBoard Member May 1, 2026
Charles W Nordstrom Individual Corporate DirectorBoard Member Jan 1, 2025
Kevin M Fitzgerald Individual Corporate DirectorBoard Member Jan 1, 2025
Gurpreet Singh Individual Corporate DirectorBoard Member Jan 1, 2025
Robert J Wiechmann Individual Corporate DirectorBoard Member Jan 1, 2025
Mayo Clinic Organization, Rochester, MN Corporation, Non-profit Operational/Managerial Control Apr 1, 2020 100%
Adam W Smith Individual Corporate OfficerCfo & Treasurer Jan 19, 2026
Corporate DirectorBoard Member Jan 19, 2026
Kelly M Buchholtz Individual Corporate DirectorBoard Member Jan 1, 2025
Janel N Glantz Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

Facilities with the same owner 38

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1003453119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860056",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BLACKHAWK AVE",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538211698",
            "telephone_number": "608-326-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5275"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System - Franciscan Healthcare Prairie du Chien",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System-Prairie du Chien",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Health System-Franciscan Medical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Prairie Du Chien, WI

Sources for this page

Verify at the official NPI Registry.